1110: Distinction Between Pseudo-Occlusion and Occlusion of Internal Carotid Artery (ICA) using Ultrasound Contrast Material (CEUS) (original) (raw)
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Role of ultrasound in detection of breast cancer: Current status
International Journal of Surgery Science, 2019
Breast Ultrasonography (US) is now a days considered the first line examination in the Screening of breast for detection of early breast lesions including cancer. Yet only few single center cohort studies analyzing breast US as screening tool could be found in literature. In spite of the fact that mammography is considered as the primary method for screening for its ability to detect microcalcifications, US is good in mass or mass like lesion detection, especially in the dense breast population as proved by the study of ACRIN 6666 (American College Of Radiology Imaging Network). A lobular hypoechoic area, lesion with ductal extension and dilatation, and a hypoechoic nodular lesion with a dilated lactiferous duct leading to the retroareolar region, were the common ultrasound findings in Ductal carcinoma in situ (DCIS) have been found. Recent introduction of Computer programmes have been developed and approved for use in clinical practice, like CAD (computer aided/assisted detection/ diagnosis), ABUS (Automated breast US), elastography and microbubbles in contrast-enhanced ultrasound. The standardized scanning, with addition of computer technology implementation and finding the picture of DCIS may prove an important radiation free modality for detecting early breast cancer. Results: Out of 176 cases in which we analysed US data and compared with histocytological findings sensitivity and specificity were 94.5% and 92.3% respectively. It was concluded that conventional USG examination can very well complement the diagnosis of breast lesions including cancer. Moreover, this method has the lowest cost/efficiency ratio and it is also the most non-invasive and easily accessible imaging method, with an accuracy comparable to MRI.
Surgery Today, 1993
Ultrasound (US) was compared with mammography (MMG), computed tomography (CT), and digital subtraction angiography (DSA) in its effectiveness to detect breast cancer masses and metastatic axillary nodes. Forty-seven breast cancer patients who all underwent MMG, US, CT, and DSA preoperatively in our institution between 1986 and 1990 were studied. US was able to detect tumors in all cases regardless of tumor size, whereas DSA detected Tl-size tumors and MMG detected T2-size tumors in 40% and 64.7% of cases, respectively, being specifically inferior to US. It was found that MMG was least likely to detect papillotubular carcinoma, although microcalcification alone without a tumor mass on MMG improved detectability from 46.2% to 76.9%, according to the histological type. CT was found to be most sensitive to axillary node metastases (81.8%), followed by US (72.7%), but DSA was significantly unfavorable (42.9%). Thus, we concluded that US was superior to MMG, CT, and DSA for detecting breast cancer masses, but that CT was more advantageous than US, while DSA was of little value for evaluating axillary nodal status.
Advantages and pitfalls of ultrasound in the diagnosis of breast cancer
Journal of Clinical Ultrasound, 1985
Ultrasound has become more and more widespread in the diagnosis of breast disease. However, opinions still diverge concerning its exact place in the diagnosis of breast cancer. An understanding and awareness of the principal pitfalls and limitations of this modality is essential for its optimum and responsible usage. An analysis of four interesting cases illustrates the benefits and limitations of this technique.
Importance of staging of breast cancer and role of contrast ultrasound
European Radiology, 2001
High-resolution ultrasound (US) can be used to evaluate most of the parameters required for breast cancer staging. However, there are major problems in the accurate definition of tumor vascularity and the detection of multifocality and axillary lymph node metastases. Clinical studies have shown that increased accuracy can be obtained by using US contrast agents but the first-generation agents are fragile and their recirculation time is quite short for them to allow US to be effective for staging in the clinical setting. However, these agents provide significant enhancement of larger vessels in the breast, which allows them to be used to increase the specificity of US for malignancy and to assist in the differentiation of surgical scaring from tumor recurrence. The secondgeneration contrast agents are more stable and provide the radiologist with ample time to conduct a thorough US examination of the breast and axilla. These new enhancing agents increase the sensitivity of US for malignant breast disease, often beyond that of digital mammography, and provide sufficient added information to allow for more reliable staging by detecting multifocality and nodal involvement.
The importance of combining of ultrasound and mammography in breast cancer diagnosis
Acta Medica Academica, 2011
Objective. The aim of this study was to analyse individual and combined sensitivity and specificity of ultrasound and mammography in breast cancer diagnosis and emphasize the importance of combining breast imaging modalities. Patients and methods. By means of a cross-sectional study, ultrasound and mammographic examinations of 148 women (mean age 51.6 ± 10.8 years) with breast symptoms were analysed. All women underwent surgery and all lesions were examined by histopathology analysis which revealed the presence of 63 breast cancers, and 85 benign lesions. In relation to age, the women were separated in to a group under 50 years and a group 50 years and older. Ultrasound and mammographic findings were classified on the BI-RADS categorical scale of 1-5. Categories 1, 2 and 3 were considered negative, while categories 4 and 5 were positive for cancer. For statistical data processing the McNemar chi-square test for paired proportions was used. The differences on the level of p<0.05 were considered statistically significant. Results. In the group under 50 years, the ultrasound sensitivity was significantly higher than the mammographic sensitivity (p=0.045, c2=4), without a statistically significant difference in specificity (p=0.24, c2=1.39). In the women over 50, a significant difference between sensitivity of ultrasound and mammography was not proved (p=0.68, c 2 =0.17), nor any difference in the specificities (p=0.15, c 2 =2.08). In the group consisting of all patients, the sensitivity of ultrasound was statistically significantly higher in comparison with the sensitivity of mammography (p=0.04, c 2 =4.27) with higher specificity (p=0.04, c 2 =4). By combining the two methods in all patients sensitivity of 96.8% was achieved, in patients up to 50 sensitivity was 90.47% and in patients over 50, sensitivity was 100%. When the two methods were combined in all patients, a decrease in specificity was noted. Conclusion. The combination of ultrasound and mammography in breast cancer diagnosis achieves high sensitivity and the number of undetected breast cancers is reduced to minimum.
Journal of Mammary Gland Biology and Neoplasia, 2006
Frequent advances in transducer design, electronics, computers, and signal processing have improved the quality of ultrasound images to the extent that sonography is now a major mode of imaging for the clinical diagnosis of breast cancer. Breast ultrasound is routinely used for differentiating cysts and solid nodules with high specificity. In combination with mammography, ultrasound is used to characterize solid masses as benign or malignant. There is growing interest in using Doppler ultrasound and contrast agents for measuring tumor blood flow and for imaging tumor vascularity. Ease of use and real-time imaging capability make breast ultrasound a method of choice for guiding breast biopsies and other interventional procedures. Breast ultrasound is used in many forms. B-mode is the most common form of imaging for the breast, although compound imaging and harmonic imaging are being increasingly applied to better visualize breast lesions and to reduce image artifacts. These developments, together with the formulation of a standardized lexicon of solid mass features, have improved the diagnostic performance of breast ultrasound. Several approaches that are currently being investigated to further improve performance include: (1) computer-aided-diagnosis; (2) the assessment of tumor vascularity and tumor blood flow with Doppler ultrasound and contrast agents; and (3) tissue elasticity imaging. In the future, ultrasound will play a greater role in differentiating benign from malignant masses and in the diagnosis of breast cancer.
Progress in cancer diagnosis with ultrasound
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
Despite successes in using ultrasound to characterize tissues at many sites in the body, the diagnosis of cancer, especially in the female breast, has remained challenging. Besides devising methods to analyze the data, there are difficulties with collecting data from enough patients to validate a variety of new methods, and in coping with changes in the hardware. We have been conducting an integrated effort for nine years that has minimized these difficulties and is approaching success.
Utility of Ultrasound Imaging Features in Diagnosis of Breast Cancer
Utility of Ultrasound Imaging Features in Diagnosis of Breast Cancer, 2023
Background Currently, breast cancer (BC) is considered one of the most prevalent cancer worldwide in women and represents a global health challenge. Early diagnosis is the keystone in the management of BC patients. This study aims to assess the utility of ultrasonography (US) features of malignancy in the diagnosis of BC. Methods This retrospective cross-sectional study involved the electronic records of 326 female patients who were diagnosed with BC. A cross-tabulation test was performed to identify the association between the presence of each US feature (yes/no), and the final US diagnosis (benign/malignant). The strength of association of each feature was measured using the odds ratio (OR) which was assumed to be significant when > 1, with a 95% confidence interval (CI). Results The mean age of the female patients involved in this study was 45.36 ±12.16 years old (range, 17-90 years). Cross-tabulation test showed a significant association between the malignancy tumor and the irregular shape of the lesion (p < 0.001, OR=7.162, CI 2.726-18.814), non-circumscribed margins (p < 0.001, OR = 9.031, CI 3.200-25.489), tissue distortion (p < 0.001, OR = 18.095, CI 5.944-55.091), and the lymph node enlargement (p < 0.001, OR = 5.705, CI 2.332-13.960). Conclusion US imaging features of malignancy have a high sensitivity and positive predictive value for detection of the BC. However, the specificity of breast US imaging features is much lower because of the overlapping features in benign and malignant breast lesions. Breast lesions with an irregular shape, not circumscribed irregular or spiculated margins, hypo-echogenicity, tissue distortion, and those with lymphadenopathy have the highest likelihood of malignancy despite the low specificity. US is a highly valuable, safe, and affordable imaging modality with high diagnostic accuracy for BC.
Clinics (São Paulo, Brazil), 2015
The purpose of this study was to evaluate the effectiveness of contrast-enhanced ultrasound with a second-generation contrast agent in distinguishing between occlusion and pseudo-occlusion of the cervical internal carotid artery, comparing it with that of conventional Doppler ultrasound and the gold standard, computed tomography angiography. Between June 2006 and June 2012, we screened 72 symptomatic vascular surgery outpatients at a public hospital. Among those patients, 78 cervical internal carotid arteries were previously classified as occluded by Doppler ultrasound (without contrast). The patients were examined again with Doppler ultrasound, as well as with contrast-enhanced ultrasound and computed tomography angiography. The diagnosis was based on the presence or absence of flow. Among the 78 cervical internal carotid arteries identified as occluded by Doppler ultrasound, occlusion was confirmed by computed tomography angiography in only 57 (73.1%), compared with 59 (77.5%) for...
Pitfalls of Contrast Enhanced Ultrasound (CEUS) in determination of breast tumor biological dignity
Neoplasma, 2018
The aim of this prospective study was to identify characteristics of breast lesions on contrast enhanced ultrasound (CEUS) that can be a source of diagnostic ambiguity and cause under-or overestimation of examined breast lesions. 215 women (range 23-76 y., mean age 53.16 y) with 215 breast lesions were examined by B-mode ultrasound, followed by CEUS and core biopsy. CEUS parameters: degree of opacification, character of washout and preliminary CEUS result (suspicious, non-suspicious, uncertain) were subsequently correlated with histopathological outcomes. Observed qualitative variables, CEUS results and their analysis with respect to histological type were evaluated using Pearson χ 2 square test, p<0.05 was statistically significant. Differences in mean lesion size, mean age of patients, mean size between groups (malignant/benign) with respect to CEUS result were evaluated by t-test. 215 tumors, 116 (53.93%) benign and 99 (46.05%) malignant lesions. 17 (14.66%) benign and 15 (15.15%) malignant lesions expressed atypical washout, 5 (4.31%) benign lesions had early washout and 38 (38.38%) had continuous washout (p<0.0001). 56 (48.28%) benign and 55 (55.56%) malignant lesions had middle degree of opacification, 19 (16.38%) benign had high and 5 (5.05%) malignant lesions low degree of opacification (p<0.0001). Finally, 38 (32.72%) benign and 20 (20.20%) malignant were marked CEUS uncertain. As risk lesions are considered fibroadenomas, fibrocystic lesions, papillomas and low grade DCIS or invasive breast tumors, especially lesions smaller than 10 mm. Identification of CEUS pitfalls with respect to problematic histopathologic entities can reduce the risk of misdiagnosis and improve further management of breast lesions.